Racial disparities in health among nonpoor African Americans and Hispanics: The role of acute and chronic discrimination

Abstract

Racial disparities in health tend to be more pronounced at the upper ends of the socioeconomic (SES) spectrum. Despite having access to above average social and economic resources, nonpoor African Americans and Latinos report significantly worse health compared to nonpoor Whites. We combine data from the parents and children of the 1979 National Longitudinal Survey of Youth (NLSY79) to address two specific research aims. First, we generate longitudinal SES trajectories over a 33-year period to estimate the extent to which socioeconomic mobility is associated with exposure to discrimination (acute and chronic) across different racial/ethnic groups (nonHispanic Whites, nonHispanic Blacks, and Hispanics). Then we determine if the disparate relationship between SES and self-rated health across these groups can be accounted for by more frequent exposure to unfair treatment. For Whites, moderate income gains over time result in significantly less exposure to both acute and chronic discrimination. Upwardly mobile African Americans and Hispanics, however, were significantly more likely to experience acute and chronic discrimination, respectively, than their socioeconomically stable counterparts. We also find that differential exposure to unfair treatment explains a substantial proportion of the Black/White, but not the Hispanic/White, gap in self-rated health among this nationally representative sample of upwardly mobile young adults. The current study adds to the debate that the shape of the SES/health gradient differs, in important ways, across race and provides empirical support for the diminishing health returns hypothesis for racial/ethnic minorities.

Discrimination in the United States: Experiences of Latinos

“…This relationship was reversed among whites, where higher socioeconomic status was associated with reporting less discrimination. These results are consistent with prior literature showing that high‐SES minorities may experience greater discrimination than their lower‐SES counterparts . However, our results do not explain why this might occur.…”

“…Other research has found that prolonged or repeated discrimination causes major health problems over time, due to progressive wear and tear on the body's systems owing to repeated adaption to stressors (known as allostatic load and overload) . We expect that on average, discrimination will have a greater effect on the health of high‐socioeconomic status and upwardly mobile Latinos, who report experiencing greater discrimination than Latinos with lower‐socioeconomic status and those who are not upwardly mobile . Discrimination also carries major consequences for Latinos' opportunities for fair treatment in education, occupations, wages, medical care, and public safety.…”

“…Previous research suggests that nationality and socioeconomic status moderate the relationship between race/ethnicity and discrimination, but their effects depend on the racial or ethnic group of inquiry (eg, whites with higher education and income are less likely to report experiencing discrimination, while blacks and Asians with higher education and income are more likely to report discrimination) . Additionally, 48 percent of Latino adults in the United States are foreign‐born, and previous studies suggest Latino groups have cultural differences related to ethnic identity, nativity, accent, and language that may be important correlates of discrimination …”

“…To date, the vast majority of existing studies on discrimination against Latinos have either relied on samples that cannot be generalized to the US Latino population (eg, small sample sizes, convenience samples, only Mexican Americans, only Latino immigrants), or have focused on everyday discrimination (unfair treatment) or discrimination within a single policy domain (such as health care) and have not simultaneously examined the extent of discrimination Latinos face across multiple institutions or policy domains.…”

Associations of overweight/obesity and socioeconomic status with hypertension prevalence across racial and ethnic groups

“…Disadvantaged minority neighborhoods usually have less access to healthy foods and recreational facilities and excess advertising for products that can influence blood pressure . Further, discrimination has been shown to affect minority health, regardless of an individual's SES . Living in neighborhoods with higher SES that are also more likely to have a higher proportion of whites may expose minorities to more discrimination because of more contact with whites .…”